Talk therapy by phone may ease fibromyalgia pain

Chronic widespread pain is a main feature of fibromyalgia, a condition that affects about 10 percent of the population and is extremely difficult to treat.

But a recent study has shown that talk therapy done over the phone helped some people suffering from this pain to feel better.

Researchers found that about one-third of people who had cognitive behavioral therapy (CBT) phone sessions felt "much better" or "very much better" after six months, compared with less than one in ten who continued their usual treatment.

CBT helps patients understand how their thoughts and attitudes affect how they feel and how they respond to situations — then addresses practical steps they can take to improve negative thoughts and outcomes.

While the technique has shown success in patients with fibromyalgia, as well as other types of chronic pain, depression and anxiety disorders, CBT isn't available everywhere and can be expensive — starting at around $100 for an hourlong session.

"One of the major, major problems with CBT is access to the therapists themselves," said John McBeth from the University of Manchester in the U.K., who worked on the study.

Doing CBT over the phone would solve the problem of availability, and sessions could be shorter and cheaper, researchers proposed.

About the study

The current study involved 442 people in the U.K. with chronic widespread pain. For six months, they were split into groups — one doing exercise, another receiving CBT, a third receiving a combination of both, and a fourth given the usual care by their doctors.

The exercise treatment included six fitness instructor-led monthly appointments, and patients were recommended to exercise between 20 and 60 minutes a day with increasing intensity over a six-month period.

About 33 percent of people who had had one or both of the treatments said they were feeling at least "much better" than before the study started. That compared with only 8 percent in the treatment-as-usual group. There was no extra benefit for those who got both CBT and exercise treatment.

For the most part, those benefits held up for another three months after treatments ended. Only a quarter of people in the exercise-only group felt better at the nine-month, mark, though, and many are likely to have stopped exercising by that point, the researchers note.

Despite the overall improvements in well-being some reported, participants didn't get any added benefit from CBT or exercise for specific pain symptoms, McBeth and his colleagues write in the Archives of Internal Medicine. Most of the treatments' benefits related to fatigue and how subjects coped with their pain.

McBeth added that while a cost analysis found that talk therapy was "marginally more expensive than we would have hoped for" given its benefits, his team is planning to look into strategies to cut its costs.

A few drugs are approved to treat fibromyalgia, including Cymbalta, Savella and Lyrica — but a combination of talk therapy and exercise remains the treatment of choice, McBeth said.

Fibromyalgia "is primarily a pain condition, but it also has a lot of disorders that co-occur with it. There's a lot of fatigue and gastrointestinal symptoms," he said. "There isn't one magic bullet that will target all those symptoms."

22 percent of people with chronic pain become depressed, studies show, and 25 percent go on to lose their jobs.

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